Sick during interviews

[Guest Lactic Folly]

Well, the cold bug's finally caught me I tried some over-the-counter medications but I'm still blowing my nose quite a lot. What can I do to minimize tearing up and sneezing all over my interviewers? Anyone else had this happen to them?

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<threadtitle>BC JW teen blood transfusion case</threadtitle>

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<username>wattyjl</username>

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<title>BC JW teen blood transfusion case</title>

<pagetext>Just wondered what other people's take on this was... other scenarios like this have been brought up here, mainly in prep for discussing ethical dilemnas in interviews.

 

BC teen blood transfusion at CBC

 

case in question is a 14yro Jehovah's Witness cancer patient refusing blood transfusion, her parents support her decision but the court ruled in favour of transfusing. the odd thing to me is that though she was not considered mature enough to make this decision, her family seemed to be behind her decision, and despite this it ends up being the court that decides her ultimate treatment. is this usually how it works for minors? they are deemed unable to make their own choices, regardless of whether they are supported by parents/family, and instead those decisions are made by 'government'?

[Guest Malikar]

Minors are usually unable to make their own decisions legally. One strange case where they can make their own decisions is in consenting to sex with an adult... 14 years of age if I recall correctly. I was rather shocked to have recently read this.

 

Minors are not able to make some of their own decisions, but their legal guardian(s) are empowered to do so. Indeed legal guardians are resposible for minors, in some cases even for criminal actions (usually only financially responsible for such actions though ).

 

I'm really not sure why the girl's guardians don't have the final say here. Apparently the "girl's doctor" (I'm assuming her oncologist, not FP, but please correct me here) will not force her to undergo transfusion. So, the girl, her parents, and her doctor all agree... the only party that doesn't is the Supreme Court. Why this is an issue with them is beyond me.

 

I wonder if those right-to-lifers who went bonkers over Terry Schivao would like to force her to be violated in this way.

 

I don't personally understand why Jehovah's Witnesses are so against transfusion, but then again I don't understand anything else about them either... But, just because I, and others, do not understand shouldn't preclude her from making this decision.

 

This issue may dissolve though, as I heard late yesterday that her hemoglobin had increased to just below normal, and she was discharged from the hospital she was at. I hope she recovers without having to continue to go through this situation.

 

Mal

[Guest canmic]

The trick here is that BC has the strictest rules about minors having no rights of any canadian province.

 

Basically, as the social worker said:

 

"the judgment upholds the state's responsibility to provide emergency medical care for minors when it is deemed necessary for survival"

 

In BC, you must be 19 or over to refuse emergency medical treatment necessary for survival. That is the law.

 

In Ontario, for example, you can refuse such treatment at age 16 (but not before).

 

In Quebec, I believe (but I'm not 100% sure) that the age is 14.

 

As far as who would have fought the case, that would have been the BC Child welfare agency, aka the social worker at the hospital where it all took place.

 

This court case was brought forward BEFORE the girl needed the blood transfusion, in order for the legal groundwork to be laid out in the event that she needed one quickly. It also set a clear precedent (which is important) for future cases, which is why the child welfare dept followed up on it so carefully.

 

What will happen next is that basically her doctor will be monitored by the hospital ethics committee to make sure that he doesn't avoid a transfusion if the established standard of care says that it is the treatment that should be done.

 

Hopefully she'll recover and do well without one.

[Guest wattyjl]

good to know canmic, but i'm still surprised that the decision doesn't fall to her parents given she is considered a minor. why does the 'decision' fall to the state?

 

this means that in ontario, regardless of the situation, decisions regarding emerg. medical care for a 15.9 yr old rest on the hospital/physician/state, not the parents? so if a 15.9yr old JW comes in and needs a transfusion, it's done and nobody bats an eye?

[Guest wylie348]

I am not sure what involvement the parents had in the decision, but I have read some ethics books that discussed similar issues. What was pointed out was that parents may not make a martyr of their child when that child is a minor.

[Guest canmic]

It all comes down to the way the law is worded.

 

Yes parents may NEVER make a martyr of their children, period.

 

But, in BC, the law specifically says that the youth protection folks (child welfare society, aka social workers at children's hospital in this case) have a specific responsibility and have the legal power to ensure that NO ONE gets in the way of the delivery of life saving treatment to anyone under the age of 19.

 

The judge said that the law does not say "no one except the parents" nor does it say "no one apart from the child themselves"

 

The law says "no one" and that's how the judge read it. So he gave the full power to the social workers to over-ride the parents and the girl's wish not to have a transfusion should she wind up needing one as a life saving measure.

 

I think the "life saving treatment" part is key here.

[Guest canmic]

In an interesting twist, the parents and girl ran off to Ontario where the laws are different to try to avoid the transfusions ordered by the BC courts, but..

 

The Ontario court found them to be in contempt of court in BC and ordered that they be escorted back to BC by the police as soon as possible for the transfusion.

 

Basically, if you break a law in one province, running to another province where the laws are different doesn't change the fact that you broke the law in the first province. AND if you have a court order in one province based on that province's laws, you can't run and hide in another province where the laws are different, because breaking a court order is illegal in all provinces..

[Guest studentz]

Canmic, are you sure about the 16 year requirement in Ontario? I was under the impression that the wishes of a competent 16+ year old must be respected, however if someone under 16 is judged to be competent, his/her decision regarding treatment can be honoured.

[Guest peachy]

I agree with you studentz - that's what CBC radio had to say about the story, anyways. In Ontario children under 16 are judged to be competent on an individual basis, so in this case it is likely that this girl would have been judged competent here.

[Guest UWOMED2005]

My understanding is that Ontario changed it's rules regarding competency just a few years ago. Before the age was defined as 16. Now, it's a matter of judging the 'maturity' of the patient in question. . . so a 13 year old might be considered competent to consent, whereas some 19 year olds wouldn't be. . .

[Guest canmic]

There was another thread about this in here somewhere and I specifically pulled the laws about what happens at what age in Ontario etc...

 

Basically there is a difference in the law between refusing a medical procedure and refusing a medical procedure that will result in your death, or an 'emergency' medical procedure etc etc...

 

But, the point is, at any age, you can't defy a court order from one province by running to another province.

 

Now, if she had left BC BEFORE the court order... who knows?

 

ps: Competancy in all provinces, has to do with mental state and impairment and NEVER to do with maturity. Ie: Someone with a brain injury, mental illness, or MR, will likely be incompetant at any age, but without any of these things, only those under 12 are considered to be too young to be competant. (But some are considered to be too young to consent or refuse consent etc...)

[Guest canmic]

Ok I dug up the info again, and in Ontario, to refuse 'life saving treatment' a person has to be 16. Or, more specifically, "after age 16 competency to refuse treatment depends on mental state and not on age".

 

In this use, "Mental state" means basically that they aren't declared incompetent, as a person can be at any age, due to mental disease, disorder or injury. It would include anything from MR to psychosis to being drunk, but it would not include being 'immature'.

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